Elif Nur Özbay

Question 1

Endemic:

Answer 1

a disease of low morbidity, constantly present in a certain
region, or among a particular group, characteristic to it, showing no or
little change by time, e.g., sleeping sickness in an African country

Question 2

Epidemic:

Answer 2

a significant increase in an infection in a certain region or a
population at the same time than is previously common at that time

Question 3

Pandemic:

Answer 3

an epidemic distributed over wide geographical areas
(worldwide), e.g., COVID-19

Question 4

Common manifestations of infections diseases :

Answer 4

Fever,loss of weight,Headache, nausea, weakness, loss of appetite, joint and muscle pain
Complaints about urination ,diarrhea,skin rash

Question 5

Maculopapular rash:

Answer 5

measles, rubella, dengue, rickettsia spotted fevers, primary HIV disease

Question 6

Vesicular rash :

Answer 6

chickenpox, **herpes zoster, disseminated herpes simplex

Question 7

Haemorrhagic rash :

Answer 7

meningococcaemia, viral haemorrhagic fevers, disseminated intravascular coagulation
**in the zona zoster

Question 8

**Congenital infections:

Answer 8

infections acquired in utero or during delivery;
TORCH, toxoplasmosis, rubella, cytomegalovirus, syphilis, HIV disease,
coxsackie virus

Question 9

Butcher,veterinarians,animal breeder:

Answer 9

Brucellosis
Q fever
Anthrax
Orf

Question 10

Fisherman, butcher, veterinarian

Answer 10

Erysipeloid

Question 11

Hunter

Answer 11

Tularemia
Rabies

Question 12

Sewage worker

Answer 12

A hepatitis
Leptospirosis

Question 13

Forest worker

Answer 13

STDs and AIDS

Question 14

Laboratory facilities

Answer 14

AIDS
Hepatitis
Brucellosis
Salmonellosis
Tularemia
Tuberculosis

Question 15

Routes of transmission of infections

Answer 15

Orofaecal route
Direct contact:
Sexual transmission:
Vertical transmission:
Air-borne transmission:
Droplet contact:
Vector-borne transmission:
Skin penetration or contact:
Animal

Question 16

Rational use of antibiotics

Answer 16

• Microbiology guides therapy
wherever possible • Indications should be evidence-
based • Narrowest spectrum required • Dosage appropriate to the site
and type of infection • Minimise duration of therapy • Ensure monotherapy in most
situations

Question 17

Me chanism of Action of antibiotics:

Answer 17

• Inhibition of Cell Wall
Synthesis • Disruption of Cell
Membrane • Inhibition of Protein
Synthesis • Interference with
Metabolic Processes

Question 18

**Using Appropriate Antibiotic

Answer 18

• Prevent the both development of the resistance to endogenous flora
and nosocomial infection • Improve patient care (The best efficacy / less toxicity) • If you have multiple options, choosing of the cheapest and most
effective as a pharmacodynamic.

Question 19

Factors affecting selection of antibiotics

Answer 19

-properties of infections:the location and characteristics of the infection
-properties of patients:age,allergies,underlying diseases,pregnancy,before used and now using antibiotics
-properties of antibiotics:spectrum,mechanisms,interval of dose,route of administration,timing,drug interactions,side effects,cost

Question 20

Pe ripheral nerves: pain, numbness, tingling

Answer 20

Aminoglycosides

Question 21

Inner ear (hearing & balance)

Answer 21

Gentamicin /Vancomycin

Question 22

Growing bones & teeth

Answer 22

Tetra c yc lines

Question 23

Liver

Answer 23

Rifampicin / Isoniazid

Question 24

Kidney

Answer 24

Gentamicin /Vancomycin /Cotrimoxazole

Question 25

Skin (photosensitivity)

Answer 25

Tetra c yc lines, Quinolones

Question 26

Hypo and hyper glicemia) and tendon rupture

Answer 26

Quinolones

Question 27

Bone marrow

Answer 27

Chloramphenicol /Cotrimoxazole

Question 28

**Ideal Antibiotic Using

Answer 28

• Correct antibiotic • Best way (IV,IM,PO) • Effective dosage • Optimal timing • Appropriate period • After correct diagnosis

Question 29

**Using Combine Antibiotics

Answer 29

They offer a broad spectrum effect with synergistic interaction • Treatment of mixed infections • Synergistic effect against P. Aeruginosa • Prevent the development of resistance • Reducing the toxicity of antibiotics ------------------------------------- • Expanding the antimicrobial spectrum • Polymicrobial infection • Serious infections in neutropenic patients • Prevent the development of bacterial resistance • Synergistic effect

Question 30

When two antimicrobial are combined invitro they may demonsrate one of the three types of interactions against a given organism

Answer 30

-additive -synergism -antagonism

Question 31

**Synergy

Answer 31

The influence of drugs combination, these drugs is the sum of the effects that Synergy result from using only a single one • 1 + 1 > 2

Question 32

Un desirable Effects of Combination Antibiotic

Answer 32

• Antogonizm • Colonisation of resistance microorganism and superinfection • Toxicity and increasing side effect • Increasing cost

Question 33

Which factor we pay attention for prescribing antibiotics

Answer 33

• Age • Physiological functions • Pregnancy • Site and severity of infection • Allergy • Antibiotic factors • Pharmacokinetic/pharmacodynamic (PK/PD) profile

Question 34

Adverse reactions to penicillin

Answer 34

-IgE antibody anaphylaxis early urticarial <72 (penicillin G) -cytotoxic antibody hemolytic anemia (penicillin G) -antigen-antibody complex disease (penicillin G)

Question 35

Adverse reactions to aminoglycoside

Answer 35

-Nephrotoxicity -ototoxocity -cochlear -vestibular

Question 36

**UTI is more common in women than men**why:

Answer 36

• short urethra • It can easily infect the urethra from the perianal region. • Sexual contact • Adhesion to the epithelium

Question 37

-The urinary system is sterile -normal flora of the urethra includes lactobacilli and staphylococci -Anaerobic microorganisms rarely cause UTIs. -Fungal agents, especially Candida species, cause infections in catheterized patients receiving antibiotic therapy. -Among viral agents, adenoviruses cause hemorrhagic cystitis in pediatric patients and allogeneic bone marrow recipients. -The kidney is frequently affected in patients with Staphylococcus aureus bacteremia or endocarditis. -In older patients, infections are mostly asymptomatic.

Question 38

**What is the most common cause of acute infection of UTI?

Answer 38

Escherichia coli

Question 39

..............causes infection in sexually active young women?

Answer 39

S. saprophyticus

Question 40

Lower urinary tract infection

Answer 40

-Urethritis,cystitis

Question 41

Upper urinary tract infection

Answer 41

Pyelonephritis Perinephritic abscess

Question 42

Protection mechanisms Of UTI

Answer 42

(1) Elimination of bacteria from the bladder by voiding (2) Antibacterial properties of urine and its constituent compounds (3) Defense mechanisms of the bladder mucosa (4) Acid environment in the vagina in women (5) Prostate secretion in men

Question 43

Risk Factors Of UTI

Answer 43

• Obstruction in urinary flow: tumor, stenosis, stone • Catheterization, urethral dilatation, cystoscopy • Renal tx

Question 44

CYSTITIS

Answer 44

• Frequent urination • Urgent urge to urinate • Burning while urinating and after urination • Suprapubic pain • Bloody and/or cloudy urine

Question 45

BACTERIURIA

Answer 45

name given to the presence of bacteria in the urine-possibility of infected urine in the bladder

Question 46

SIGNIFICANT BACTERIURIA

Answer 46

Presence of at least 100,000 bacteria per ml

Question 47

ASYMPTOMATIC BACTERIURIA

Answer 47

the presence of significant bacteriuria without symptoms in the patient

Question 48

Complicated UTIs

Answer 48

Includes UTIs occurring in the presence of urologic abnormalities and UTIs in pregnancy.

Question 49

RELAPS

Answer 49

Recurrence of bacteriuria with the same causative organism despite treatment

Question 50

REINFECTION

Answer 50

recurrence of infection with a different microorganism - a new infection

Question 51

UROSEPSIS

Answer 51

Development of sepsis syndrome due to UTI

Question 52

**HOW TO TAKE A URINE SAMPLE?

Answer 52

• Midstream urine is collected. • The most suitable sample is the first urine in the morning. -in women first the vaginal entrance is cleaned with gauze impregnated with water-sf , antiseptics can lead to low bacterial counts -clean urine has a clear appearance,cloudy appearance in infection. -bad odor may indicate infection

Question 53

**However, this test is positive in Enterobacteriaceae (E.coli, Klebsiella, Proteus etc.) members, it may be negative in the presence of some factors.

Answer 53

• Acinetobacter • Pseudomonas • Staphylococcus saprophyticus • Enterococcus • Even if the urine is very dilute, it may be negative.

Question 54

Normal urine pH

Answer 54

5.5-6.5

Question 55

Culture is essential in complicated or recurrent UTI.

Question 56

**Sterile pyuria agents:

Answer 56

• Chlamydia • Mycoplasma • Ureoplasma • Trichomonas • Gonococci • Candida • Tbc • Stone • Foreign body • Glomerulonephritis

Question 57

N.gonorrhoeae urethritis

Answer 57

• Incubation periodis short (4 days) • It is of sudden onset. • Dysuria • Purulent discharge • Dysuria and discharge coexistence • Spontaneous discharge and hyperemia in the urethral meatus

Question 58

C.trachomatis, U.urealyticum, M.genitalium, H.simplex, Adenovirus, T.vaginalis (Urethritis)

Answer 58

• Incubation periodis variable (2-35 days), usually long. • It starts within days. • Dysuria • Mucopurulent or serous discharge • There is either discharge or dysuria. • Spontaneous discharge and hyperemia in the urethral meatus

Question 59

Nosocomial Infections

Answer 59

Nosocomial infections also referred to as healthcare-associated infection* (HAI), are infection(s) acquired during the process of receiving health care that was not present during the time of admission to the hospital. ** Infections may be caused by a microorganism acquired from another person in the hospital (cross-infection)  Infections may be caused by the patient’s own flora (endogenous infection).  Some organisms may be acquired from an inanimate object or substances recently contaminated from another human source (environmental infection).

Question 60

How do we classify? Types of Healthcare-Associated Infections

Answer 60

 Central line-associated bloodstream infections (CLABSI)  Catheter-associated urinary tract infections (CAUTI)  Surgical site infections (SSI)  Ventilator-associated pneumonia (VAP)

Question 61

Important patient factors influencing acquisition of infection include

Answer 61

Age,immune status,chronic disease

Question 62

.........are the most common pathogens for HAIs, followed by fungi and viruses. .............is the least

Answer 62

Bacteria (most) Parasitic (least)

Question 63

Bacteria of nosocomial inf

Answer 63

 Common Gram-positive organisms include coagulase-negative Staphylococci, Staphylococcus aureus, Streptococcus species, and Enterococcus species (e.g. faecalis, faecium).  Methicillin-resistant S. aureus (MRSA) transmit through direct contact, open wounds and contaminated hands. It causes sepsis, pneumonia and SSI by travelling from organs or bloodstream. It is highly resistant towards antibiotics called beta-lactams.  Acinetobacter spp.  Bacteroides fragilis is a commensal bacteria found in intestinal tract and colon. It causes infections when combined with other bacteria  Clostridium difficile cause inflammation of colon leading to antibiotic-associated diarrhea and colitis, mainly due to elimination of beneficial bacteria with that of pathogenic.  C. difficile is transmitted from an infected patient to others through healthcare staff via improper cleansed hands  Enterobacteriaceae (carbapenem- resistance) cause infections if travel to other body parts from gut; where it is usually found. Enterobacteriaceae constitute Klebsiella species and Escherichia coli. Their high resistance towards carbapenem causes the defense against them more difficult. Gram-negative organism:Klebsiella pneumoniae and Klebsiella oxytoca, Escherichia coli, Proteus mirabilis, and Enterobacter species; Pseudomonas aeruginosa, Acinetobacter baumanii…

Question 64

What are the resistant bacteria that can cause hospital infection?

Answer 64

 Methicillin-resistant Staphylococcus aureus (MRSA),  Vancomycin-resistant Staphylococcus aureus (VRSA)*Not much in Turkye  Vancomycin-resistant Enterococcus (VRE)* We have in our Hospital  Enterobacteriaceae and Acinetobacter species, and multi-drug resistant Pseudomonas aeruginosa* These are also very common in our hospitals

Question 65

Which hospital infection is most common?

Answer 65

C.difficile

Question 66

Viruses oh nosocomial inf

Answer 66

 Healthcare-acquired hepatitis B and C and human deficiency virus (HIV) has been implicated in unsafe needle practices. (needle injury)  Other reported viral pathogens include rhinovirus, cytomegalovirus, herpes simplex virus, rotavirus, and influenza. (transmitted by respiratory or fecal-oral transmission)

Question 67

Fungi

Answer 67

C. albicans, C. parapsilosis, C.glabrata

Question 68

Pathogens associated with healthcare-associated infection (HAI) may have different routes of transmission.

Answer 68

- The most common route of transmission is through contact, whereby the organisms are transmitted by direct or indirect contact.  Common microorganisms that may be transmitted through contact are multidrug- resistant bacteria (such as MRSA, ESBL-producing Gram-negative organisms, VRE), C. difficile, and rotavirus. - Droplet transmission may occur when microorganisms are transmitted from the respiratory tract by large droplets (greater than 5 microns) and travel less than 3 feet  Examples of infectious pathogens that are transmitted via the droplet route include influenza, Bordetella pertussis, and Neisseria meningitidis - Airborne transmission involves the transmission of organisms from the respiratory tract by small droplets (less than 5 microns) that travel long distances  Chickenpox virus, tuberculosis, measles, and the novel SARS-COV-2 virus may be transmitted through the airborne route

Question 69

**Risk factors for Central Line-Associated Blood Stream Infection

Answer 69

Tu axa has

Question 70

What are the risk factors of CAUTI

Answer 70

 The most critical risk factor for CAUTI is the duration of catheterization.  Operative or insertion protocol, such as nonadherence to aseptic techniques, is another modifiable risk factor.  Patient characteristics that predispose to increased risk are female sex, paraplegia, cerebrovascular disease, older age, diabetes mellitus, history of UTI in the preceding year, and recent antibiotic use within 90 days

Question 71

Procedure-related risk factors include  Duration of surgery  Wound type (clean/dirty)  Hypothermia and hypovolemia during surgery  Hypoxemia,  The urgency of surgery  More than one intervention/surgery  Necessity for blood transfusion  Type of prosthesis implanted

Answer 71

The most critical risk factor is the duration of operation due to the time that the tissue is exposed to the environment leading to an increased chance of contamination

Question 72

**Hospital-acquired pneumonia (HAP)

Answer 72

pneumonia that develops after 48 hours of admission.

Question 73

**Ventilator-associated pneumonia (VAP)

Answer 73

develops after 48 hours of endotracheal intubation.

Question 74

***When we should wash our hands?

Answer 74

 Before touching a patient  Before clean/aseptic procedures  After body fluid exposure/risk  After touching a patient  After touching patient surroundings